Learning Disability Service

Tier 4 re-design

Members of the public are playing an influential role in the re-design of the Tier 4 Learning Disability Service through their role in the project team.

This development was prompted in 2006 by the merger of Clyde from the former NHS Argyll and Clyde, with NHS Greater Glasgow, and the 10th anniversary of the landmark national policy of moving from large-scale institutional care to community-living options for people with learning disabilities.

A Tier 4 Steering Group and Sub-group formed in 2008 has a wide ranging membership including carers, advocacy representatives, clinicians, managers, local authorities and local staff.

It identified people affected by the change as every patient who had used or could be expected to use longer-stay and assessment and treatment services and their carers.

Next, over a two year period, every patient of the inpatient service received a user-friendly questionnaire and the offer of a visit from a specialist LD Speech and Language Therapist to assist them to complete it.

Carers and advocacy groups were also identified as key participants to be invited to take part because of their support needs to take part in an options appraisal.

Feedback is provided through a quarterly newsletter circulated to all Learning Difficulty Community Teams, Public Partnership Forums (PPFs) and service areas.

This approach demonstrated the capacity of people with high support needs to make a worthwhile contribution to service redesign.

An independently user form will make sure that public partners play an on-going role in the service re-design and they are in regular contact with the steering group.

Everyone involved has also learned the importance of being flexible and taking time to enable the public participants to be properly informed and supported.

A particular strength is the link to clinical governance which means that feedback from the re-design and public partners is acted upon and influences services.